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| VistA - The First Amputation |
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 Posted by Scott Shreeve, MD on Wednesday November 07, 2007 @ 01:12 AM
from the VistA dept.
In an unprecedented announcement, the VA has signed a 9 year deal with Cerner to replace laboratory information system at 150 hospitals and 800 clinics. Digg this article
This is both a highly concerning but also highly provocative announcement given its implications. Which side of the sword you will feel as a result depends on your perspective.
Is there a VistA community that can respond?
U.S. Department of Veterans Affairs Selects Cerner Corp. Laboratory Technology
KANSAS CITY, Mo. — Nov. 6, 2007 — Cerner Corp. (NASDAQ: CERN) today announced a nine-year agreement for the United States Department of Veterans Affairs (VA) to utilize Cerner Millennium® PathNet® laboratory information system in more than 150 hospitals and 800 clinics in the Veterans Health Administration system.
"Looking to increase patient safety in its clinical laboratories, the VA has made the decision to use the Cerner PathNet solution, embracing the new technology also chosen by the Department of Defense for its laboratories," said Mike Valentine, Cerner executive vice president. "This coordinated strategy will help both agencies to better serve all U.S. veterans."
The Millennium PathNet laboratory information system is a comprehensive, integrated technology that automates both the clinical and managerial sides of the laboratory, and it is the only system of its kind to do so. Patient safety increases when specimens are quickly processed, tested and classified. Faster answers mean faster decisions for doctors, nurses and families. The suite of PathNet solutions tracks specimens from collection through testing and storage, and it helps unify workflow through bar codes, robotics and instrument interfaces. In addition to streamlining workflow in the laboratory, PathNet can reduce turnaround times through automatic verification and reporting. The system simplifies the process of entering results, tracking repeat entries and corrections.
This will be the largest implementation of PathNet to date for Cerner. Coupled with the Department of Defense, another Cerner client, these federal implementations represent approximately five percent of all U.S. hospitals. Additionally, this implementation means that clinical laboratories for all service members, past and present, will be operating on the same laboratory information software.
"Like the rest of the healthcare industry, the VA is modernizing and expanding its informatics infrastructure. Cerner’s proven laboratory solution is a core component of that objective," said Gary Dickerson, Cerner’s director of federal programs. "Cerner is proud to work together with the VA to serve our nation’s veterans. It is our distinct honor to be able to provide technology that helps to deliver the healthcare and recovery of our servicemen and women."
The VA will install a broad set of PathNet laboratory solutions during the three-phase implementation program in an effort to streamline complex workflows, help eliminate errors and improve the quality and performance of laboratories. Additionally, the VA will employ Cerner’s Millennium Helix™ solution for molecular testing, a Human Leukocyte Antigen module for testing tissue compatibility, and robotic interfaces in its more advanced clinical laboratory settings.
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Re: VistA - The First Amputation
by Ignacio H. Valdes, MD, MS on Wednesday November 07, 2007 @ 11:38 AM
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Anonymous sources say that this isn't the first time that the VA has tried to 'modernize' with 'commercial' aka 'proprietary' software. Previous efforts have been either abandoned or eternally 'still in progress' when it was found that the existing VistA system substantially outperformed fill-in-the-blank 'commercial' (proprietary) health IT software either in functionality or financially or both. However, after these contracts get signed, the proprietary vendor gets paid whether it is actually implemented or not. Interesting world we live in.
-- IV
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Re: VistA - The First Amputation
by Tim Cook on Thursday November 08, 2007 @ 10:27 AM
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Well, I won't be anonymous but I will be vague in that I cannot remember the presentations per se. However, at the 2002 OSHCA Conference there were US Dept. of Defense / VistA Reps. that talked about a move to proprietary systems then. We eventually learned that those approaches failed when put up against VistA they just did not stack up.
Sorry you'll have to do your own URL searches. I simply do not have the time at this point but you can trust me that they exist.
I believe that VistA has a great future in the US and "maybe" in secondary care elsewhere? I believe that the openEHR (http://www.openehr.org) specifications are more the ultimate in defining healthcare (esp. primary care) on a worldwide basis.
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Re: VistA - The First Amputation
by Matt King on Thursday November 08, 2007 @ 12:43 PM
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I would really like to write a letter similiar to this to the right Congressman and would encourage everyone else to also write one. Does anyone have names and emails or addresses to the "right congressmen or women?
Dear Honorable Senator,
I was appalled to hear that the VA awarded Cerner millions of taxpayers money for VA work. The VA has their very own able programmers who can tackle this job; instead, this is another example of wasting public money.
Worse, it wastes money on another, more catastrophic level: Much of the VA software for health care is in public domain. This software is already becoming a part of the healthcare crisis solution as a low cost, high quality EHR already proven capable of saving American lives. Choking this flow of information to the public is a colossal waste of resources, stifles innovation in the private sector and this will not be popular with American tax-payers who deserve to leverage their dollars in the most cost effective ways.
Please understand that while the VA is focused on Veterans, a symbiotic community has evolved that greatly magnifies the impact of any investments the VA makes. This magnification is still in it infancy but has tremendous untapped potential that is off most policy makers'radar. A proprietary solution in the VA will seriously hamper the trickle down of software to the underserved and uninsured population. Given that affordability and sustainability of software will continue to be a major stumbling block to leveraging HIT, policy makers should be especially sensitive to solutions or even potential solutions in health systems!
Please re-consider this strategy! The Veterans Administration has proven time and time again that they are the best health care system in the United States and possibly the world. They do this at significantly lower costs than other US systems. Up until now, I was always happy to pay taxes for Veterans Care. Why are you trying to fix them? There are a lot of other things that need your attention.
Thank you,
Matt King
Humble Taxpayer
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Re: VistA - The First Amputation
by Michael E Brown on Thursday November 08, 2007 @ 03:58 PM
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All I can say is follow the money trail. The VA outsources its Compensation and Pension program to its former Secretary (Principi), and the newly nominated Secretary comes from that same organization (QTC).
Just remember the 285 million dollar IT fiasco in Florida for the VA that costs several career VA employees their jobs. This is wrong and comes on the heals of the VA budget problems, poor care, and massive delays in care.
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